Alzheimer’s disease a huge cost financially and emotionally

By Erin Stone estone@mrt.com

Published
10:25 am CDT, Tuesday, September 29, 2015

Residents of Manor Park, area residents as well as family members touched by Alzheimers listen and take notes Monday 9-21-2015 at a panel discussion on the state of Alzheimers in Cowden Clubhouse in ManorPark. Tim Fischer\Reporter-Telegram less

Residents of Manor Park, area residents as well as family members touched by Alzheimers listen and take notes Monday 9-21-2015 at a panel discussion on the state of Alzheimers in Cowden Clubhouse in ManorPark. ... more

Photo: Tim Fischer

Photo: Tim Fischer

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Residents of Manor Park, area residents as well as family members touched by Alzheimers listen and take notes Monday 9-21-2015 at a panel discussion on the state of Alzheimers in Cowden Clubhouse in ManorPark. Tim Fischer\Reporter-Telegram less

Residents of Manor Park, area residents as well as family members touched by Alzheimers listen and take notes Monday 9-21-2015 at a panel discussion on the state of Alzheimers in Cowden Clubhouse in ManorPark. ... more

Photo: Tim Fischer

Alzheimer’s disease a huge cost financially and emotionally

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Steve Rossler sees the path ahead of him quite clearly. His mother, 88, was diagnosed with dementia two years ago. Though she’s currently responding well to medication, he knows this won’t continue, especially if her dementia turns out to be Alzheimer’s disease, the most common form of dementia.

“Later life is hard and all that,” Rossler said. “After you quit making money, your money goes pretty quick. I know the Medicare won’t kick in until you have nothing. Sooner or later ... she’ll be completely out of money. I won’t have the money to help her, and she’ll have to come live with us (he and his wife), and we’ll see how that goes. And if she starts wandering off, then we’ll have to put her in a home.”

The growing rate of Alzheimer’s and other forms of dementia has been labeled an epidemic by the Alzheimer’s Association. With baby boomers reaching the age at which early-onset Alzheimer’s becomes evident — it often appears in the 40s or 50s — there is a large population that will be need long-term care, putting a strain not only on families, but also on the already too-few caregivers, nursing aides and nurses who are essential to quality long-term care.

Alzheimer’s is the most expensive disease in America, surpassing both heart disease and cancer, according to research from the Alzheimer’s Association. In 2014, caring for people with Alzheimer’s and other forms of dementia cost the nation about $214 billion, according to the association. This year, it’s estimated to cost $226 billion, according to Dr. Don McLarey, who works in internal medicine and hospice and palliative care in Midland.

The cost impacts government budgets, but it also devastates families financially and emotionally. A medication called Namenda is prescribed, usually in combination with Aricept, to treat moderate to severe Alzheimer’s. Rossler’s mother is responding quite well to Namenda, but the cost is high.

Allergan PLC — formerly Actavis — acquired Forest Laboratories last year. Forest Laboratories originally manufactured Namenda. Allergan is embroiled in a lawsuit to discontinue the 5 mg and 10 mg two-a-day tablets, leaving only its newer once-daily capsule Namenda XR available, according to an article by the Associated Press. This move by the pharmaceutical company would blunt generic competition and force its users to switch to Namenda XR, which will be covered by a patent until 2025. This means no generic version will be available in the near future.

In 2014, New York Attorney General Eric Schneiderman sued Actavis and Forest, accusing them of violating antitrust law. In December, a federal appeals court ruled against Allergan, ordering the company to continue selling the older version of Namenda until at least 30 days after generic versions went on sale, according to the Associated Press article. That ruling was upheld in May.

“The Namenda (XR, 28 mg dosage) is about $340 a month,” Rossler said. (His mother) takes a pill a day. It’s basically a $4,000-a year prescription. It’s not covered by Medicare or supplemental Medicare. And the reason is because it’s a new drug. They have protection on that drug for at least 10 years. There’s no generic substitute for it. If you can get the doctor to prescribe not the maximum dose — and she’s on the maximum dose at 28 g — then there’s a generic for that.”

If patients were forced to move onto the newer Namenda, it could cost Medicare Part D as much as $288 million during the last six months of 2015, according to a recent analysis by the U.S. Department of Health and Human Services.

Either way, Namenda usually isn’t helpful for more than two years, said Janet Cross, program specialist for Midland chapter of the Alzheimer’s Association, at a recent panel discussion on the state of Alzheimer’s disease in the Permian Basin.

There is neither a cure for nor a way to prevent Alzheimer’s.

“You have to do the best that you can every day,” Rossler said. “Because once you turn negative, it’s hard getting back to positive.”

Texas ranks fourth in the nation in the number of Alzheimer’s disease cases and second in the number of Alzheimer’s disease deaths, according to the association.